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Reviewed by A. Kim Clark (Department of Anthropology, University of Western Ontario)Published on H-LatAm (April, 2002)

Situating Healing in the Nineteenth-Century Andes

Situating Healing in the Nineteenth-Century Andes

In 1872, a riot occurred in Bogota in which the supporters of the healer Miguel Perdomo Neira--a large proportion of the urban population--confronted professional physicians and medical students, members of the emerging, but still far from consolidated, medical establishment. The dispute was touched off by the mysterious death of one of Perdomo's patients, but as David Sowell shows, the roots of this conflict went much deeper. In attempting to contextualize this confrontation, Sowell develops an analysis of competing medical ideologies in an era of important social transition. Ultimately, he argues that the appeal of Miguel Perdomo's healing practices in Colombia and Ecuador were likely due to the fact that they were situated within a broadly accepted ideological framework of nineteenth-century Hispanic culture, including, for instance, the fact that they were permeated with ideas of Christian charity. The proponents of scientific medicine, in contrast, were trying to place healing on a new footing; in this sense, professional physicians did not speak the same language, in terms of medical ideology, as the majority of the population. Nonetheless, in the mid- to late-nineteenth century they were engaged in a process of establishing their own practices as "official medicine," and were perhaps especially sensitive to the arrival of an untitled healer with a large and enthusiastic following of patients who claimed that he had been able to heal them (sometimes painlessly) when other healers and physicians had failed.

Sowell has undertaken a difficult task in this book. While there is significant material available to understand the history of medical institutions as such, as well as analyses from medical anthropology which explore a wide range of healing traditions in the present, the sources available for understanding alternative healing in the nineteenth century are very limited. In order to cast some light on the social dynamics underlying the conflict in Bogota, and similar conflicts previously in Quito, Sowell begins by surveying the range of healing systems in the northern Andes prior to these confrontations. In so doing, he provides a useful overview of the historical roots of the various components making up what he calls the colonial medical spectrum. He then turns to the emergence of scientific medicine, examining its underlying assumptions and the specific history of processes of medical professionalization and institutionalization in Colombia and Ecuador. Only then does Sowell delve into "The Life and Times of Miguel Perdomo Neira," as he entitles his third chapter. Here we learn, among other things, about Perdomo's healing practices, many of which he apparently developed in a period when he lived among an indigenous group. The components of his medical kit in particular seem to have been based on Indian drugs, although his use of them fit within the treatment ideologies of humoralism (in which imbalances of hot and cold, wet and dry elements are thought to underlie poor health), an important current in Hispanic medicine. This chapter also includes a discussion of the details of the conflicts between Perdomo and his supporters, on the one hand, and professional physicians, on the other. The fourth and final chapter in the book examines what Sowell calls the emergence of medical pluralism. Despite the acceptance of allopathic (scientific) medicine as official medicine in Colombia and Ecuador, most Colombians and Ecuadorians are neither entirely convinced by its claims, nor do they have extensive access to this form of medical practice. Instead, these countries are today characterized by medical pluralism, in which people select eclectically among various healing traditions, broadly divided among scientific and traditional or social medicine, as they seek improved health.

In pulling together his analysis, Sowell draws on general histories of medicine, histories (and historical documents) of Colombian and Ecuadorian medicine, medical anthropology, and, for the analysis of Perdomo himself, nineteenth-century newspapers, testimonials about Perdomo's healing powers, and a book written by Perdomo about Catholicism. The testimonials in particular offer a glimpse into the world of the mid-nineteenth century, in which sick people sought various kinds of relief from their illnesses, often in vain. One of the attractions of Perdomo's healing was that he was rumored to undertake surgery painlessly, and with little bleeding. Given the conditions of nineteenth-century scientific medicine, this was a remarkable accomplishment, and seems to have been due to the indigenous plant preparations that made up his medical kit. Testimonials and newspaper articles provide vivid accounts of Perdomo's visits to towns and cities in the Colombian and Ecuadorian Andes, which bring Sowell's analysis to life. At the same time, the way that the author contextualizes Perdomo's work within the colonial medical spectrum makes this a book that will be useful for teaching purposes. On another level, Sowell's frank disclosure of the difficulties he encountered in developing an analysis around the intriguing, but ultimately sparse, newspaper accounts of the conflicts over Perdomo's visit to Bogota, will be useful for teaching graduate students who are facing the task of developing their own analyses from data that are always partial.

As an Ecuadorianist, I was a bit disappointed by the weight of the Colombian material in Sowell's analysis of Perdomo's work in these two countries. Sowell admits that as a Colombianist he was more familiar with Colombian sources, and that there were also simply more sources available for Colombia than Ecuador. While I appreciated his effort to include a discussion of Perdomo's visits to Ecuador, I nonetheless hoped for a more thorough analysis of the Ecuadorian processes. In an ideal world, Sowell's analysis would also have been strengthened by the use of local archives to situate Perdomo's visits to smaller towns within local social processes. I say "in an ideal world" in recognition of the fact that the logistics of gaining access to multiple local archives, and then developing a sufficient understanding of local processes to properly locate Perdomo's visits within them, would be a Herculean task. Even the use of one town archive, however, would have provided additional richness to this analysis. Despite these minor points, I recommend this book as a rare look into the appeal and practices of social medicine in the nineteenth century, and into the processes by which professional medicine sought to displace other forms of healing. If Sowell's book suggests points that merit additional analysis, then we can hope that this might provide a stimulus to other researchers to further explore these revealing but neglected themes in the nineteenth-century Andes.

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